James Reich1. 1. Department of Psychiatry and Behavioral Science, Stanford Univerity, CA, USA. jhreich@ix.netcom.com
Abstract
BACKGROUND: The current definitions of personality disorder indicate early onset, long duration and disorders of relatively stable severity. It has been noticed by a number of authors and researchers that at times personality pathology can be quite variable and not fit that model. METHODS: This report examines the possibility that there is a valid psychiatric disorder whose key feature is episodic personality dysfunction. The disorder would be designated State personality disorder (State PD) to separate it from Trait personality disorder (Trait PD), which is the non episodic form, and from no personality disorder (No PD). This report examines what criteria might be necessary to validate such a diagnosis. RESULTS: It finds that State personality disorder has been identified in two distinct populations and in both it can be distinguished from its near neighbor disorders of Trait PD and No PD. The family history method of personality clusters distinguishes State PD from its near neighbors and provides a possible biological marker for the disorder. In two separate populations the disorder is related to an independent measure of the hypothesized underlying personality construct. Although the two populations in which the phenomenon has been clinically identified are very different and cannot be directly compared, in both it appears that clinical variables may distinguish State PD from its near neighbor diagnoses. State PD appears to have a negative relationship to suicidal ideation and might affect the course of treatment of comorbid Axis I disorders. CONCLUSIONS: It is concluded that State PD represents a valid diagnostic entity.
BACKGROUND: The current definitions of personality disorder indicate early onset, long duration and disorders of relatively stable severity. It has been noticed by a number of authors and researchers that at times personality pathology can be quite variable and not fit that model. METHODS: This report examines the possibility that there is a valid psychiatric disorder whose key feature is episodic personality dysfunction. The disorder would be designated State personality disorder (State PD) to separate it from Trait personality disorder (Trait PD), which is the non episodic form, and from no personality disorder (No PD). This report examines what criteria might be necessary to validate such a diagnosis. RESULTS: It finds that State personality disorder has been identified in two distinct populations and in both it can be distinguished from its near neighbor disorders of Trait PD and No PD. The family history method of personality clusters distinguishes State PD from its near neighbors and provides a possible biological marker for the disorder. In two separate populations the disorder is related to an independent measure of the hypothesized underlying personality construct. Although the two populations in which the phenomenon has been clinically identified are very different and cannot be directly compared, in both it appears that clinical variables may distinguish State PD from its near neighbor diagnoses. State PD appears to have a negative relationship to suicidal ideation and might affect the course of treatment of comorbid Axis I disorders. CONCLUSIONS: It is concluded that State PD represents a valid diagnostic entity.